My Name is Paul H Cosentino. I started this Blog in 2011 because of what I believe to be wrongdoings in town government. This Blog is to keep the citizens of Templeton informed. It is also for the citizens of Templeton to post their comments and concerns.

Paul working for you.

Friday, July 14, 2017

More than 400 people charged in $1.3 billion federal health fraud sweep, including two in Massachusetts

More than 400 people charged in $1.3 billion federal health fraud sweep, including two in Massachusetts

Four-hundred and twelve people have been charged in
connection with $1.3 billion in fraud against public health care
programs, in what the Department of Justice is calling the largest bust
in the 10-year history of the Medicare Fraud Strike Force.

The enforcement action, which also swept up two defendants in
Massachusetts, has led to charges against 115 medical professionals and
suspension actions for 295 doctors, nurses and pharmacists, the DOJ said
in a press release.

And 120 of the defendants were charged in connection with the prescription of opioids and other narcotics.

"Too many trusted medical professionals like doctors, nurses and
pharmacists have chosen to violate their oaths and put greed ahead of
their patients," Attorney General Jeff Sessions said in a statement.
"Amazingly, some have made their practices into multimillion dollar
criminal enterprises. They seem oblivious to the disastrous consequences
of their greed. Their actions not only enrich themselves often at the
expense of taxpayers but also feed addictions and cause addictions to
start."

The Massachusetts Attorney General's Office coordinated with federal
authorities on the investigation and arrested two people on Monday who
allegedly stole $2.7 million from the state's Medicaid program.

Elena Kurbatzky, 44, of Boston, and 43-year-old Natan Zalyapin of
Burlington are facing multiple counts of Medicaid false claims and
larceny for allegations that their company, Harmony Home Health
Care, billed Medicaid for nursing services that were not actually
provided.

"The AG's investigation revealed that betweenFebruary
2015 and October 2016, Harmony billed MassHealth for home health
services allegedly provided to 38 patients, but either provided no
services to those patients or billed for more services than were
actually provided," the Attorney General's Office said in a statement.
"Specifically, authorities allege that on numerous instances, Harmony
billed MassHealth for nurses who allegedly provided services to several
patients in different locations at the exact same time, so those
services could not physically have been performed as claimed."

The investigations focused on providers who submitted false claims to
Medicare, Medicaid and TRICARE, a health program for service members
and veterans. Some treatments were allegedly medically unnecessary and
others were never provided at all, the DOJ said.

And many of the schemes allegedly involved the payment of kickbacks
to patient recruiters and beneficiaries in exchange for patient
information that could be fraudulently submitted to federal health
programs, according to the DOJ.

"This week, thanks to the work of dedicated investigators and
analysts, we arrested once-trusted doctors, pharmacists and other
medical professionals who were corrupted by greed," Acting FBI Director
Andrew McCabe said. "The FBI is committed to working with our partners
on the front lines of the fight against heath care fraud to stop those
who steal from the government and deceive the American public."

The bulk of the charges stemmed from federal investigations, by both
U.S. attorneys offices and the Department of Justice and the Department
of Health and Human Service's Medicare Fraud Strike Force. 77 people
were charged in the Southern District of Florida, 32 in the Eastern
District of Michigan and 26 in the Southern District of Texas due to
strike force actions, the DOJ said.

"In one case, the owner and operator of a purported addiction
treatment center and home for recovering addicts and one other
individual were charged in a scheme involving the submission of over $58
million in fraudulent medical insurance claims for purported drug
treatment services," the DOJ said. "The allegations include actively
recruiting addicted patients to move to South Florida so that the
co-conspirators could bill insurance companies for fraudulent treatment
and testing, in return for which, the co-conspirators offered kickbacks
to patients in the form of gift cards, free airline travel, trips to
casinos and strip clubs, and drugs."

But in some states -- including Massachusetts -- the charges were
driven by state-level Medicaid Fraud Control Units, who coordinated with
federal authorities.

Statistics released by the Justice Department show a steady rise in
arrests linked to federal health care fraud investigations, from 89 in
2013, to 301 last year, to 412 so far in 2017.